The Rocky Mountain News just published my op-ed opposing socialized medicine in Colorado. It was edited slightly, and this is the version that appeared in print:
Free market holds key to ensuring quality for Coloradans
By Paul Hsieh, M.D.
June 2, 2007
The Colorado Blue Ribbon Commission on Health Care Reform recently selected four health care reform proposals for eventual consideration by the Colorado legislature. Although they differ in their details, these differences are dwarfed by their fundamental similarity - they all entail a massive increase in government interference in medicine in the name of "universal coverage."
All four plans inject government force into the doctor-patient relationship. They include some combination of forcing all residents into a single health program, forcing some or all individuals and/or businesses to purchase a state-approved insurance policy, requiring insurance companies to provide new additional benefits, establishing a new bureaucracy to set payments to the doctors for services they provide, and doubling the Colorado Medicaid population.
These are just disguised forms of socialized medicine.
Similar programs already have been tried in states and other countries. They have all failed, resulting only in higher costs and lower quality patient care. The TennCare disaster - Tennessee's failed attempt at "universal coverage" - offers an important lesson for Colorado.
In the 1990s, the Tennessee government expanded the state Medicaid program to include people earning up to 300 percent of the federal poverty line, i.e., a middle-class family of four making $55,000 a year. The state also forced insurance companies to offer expensive new benefits and forced employers to either buy health insurance for their employees or else pay into a state fund for the uninsured. Many employers chose the second option, shifting their employees' health costs onto taxpayers. Because of the new regulations, many insurance companies withdrew from Tennessee, forcing more patients into the state health plan.
The Tennessee government initially offered a generous benefits package. Predictably, costs skyrocketed because patients had no incentives to spend prudently. In response, the government attempted to control costs by slashing payments to doctors and hospitals.
Hospitals closed and doctors left the state in droves. Many doctors who remained stopped seeing TennCare patients since they lost money on each one. Families with sick children often had to drive long distances to find a doctor who would see them. And they had no alternatives to TennCare because the state regulations had all but destroyed the insurance market. Ironically, TennCare ended up causing the most harm to the very people it was intended to help - the working poor and rural patients.
Nor did TennCare save money. Instead, it nearly bankrupted the state budget.
The problems of TennCare are not aberrations that can be fixed with a few minor reforms. They are inherent in any system of government medicine. Under such systems, bureaucrats and politicians decide what care individuals can receive, not doctors and patients. This has long been the case in Canada's "single-payer" socialized medical system, with its infamous waiting lists for critical medical tests and treatments. For the sake of my patients and myself, I don't want this to happen in Colorado.
Socialized medicine is not the cure for Colorado's health care problems. Forcing everyone into a government-run medical program because some people are uninsured would be just as wrong as forcing everyone to live in a government-run housing project because some people are homeless.
Instead, Colorado should adopt free market reforms such as the FAIR Program ("Free-Markets, Affordability & Individual Rights") proposed by Brian Schwartz, Ph.D. Such programs are especially good at providing affordable quality care for the working poor and rural patients. They work precisely because they encourage individual responsibility and they respect the right of the individual to spend his health care dollar according to his best judgment.
Colorado has an opportunity to become a real innovator in health care reform. Instead of recycling failed government programs, we should set an example for the rest of the country by adopting free market solutions. Only the free market can provide Coloradans with the high-quality, affordable health care they need and deserve.
Dr. Paul S. Hsieh is a practicing physician in the southern metro area. He is a founding member of the Colorado group Freedom and Individual Rights in Medicine.